NURSING HOME EXPECTATIONS AND MENTAL HEALTH AMONG OLDER ADULTS IN THE HEALTH AND RETIREMENT STUDY

Abstract Three million older adults live in long-term care facilities. Transitioning into a nursing home is a major life event that can worsen mental health. Expectedness of nursing home transitions may have implications for mental health; however, this area is understudied. This study examined the relationship between expectations of transitioning into a nursing home in the next five years and depressive symptoms and passive suicidal ideation, and how social integration modified these relationships. Sample included respondents aged 65+ from the 2018 Health and Retirement Study (n=7,944, mean age=73.9, 55.4% female, 80.5% Non-Hispanic White). Nursing home transition expectations were modeled continuously (range: 0-100%). Mental health outcomes were assessed by the Composite International Diagnostic Interview-Short Form. Social integration measured composition, frequency of contact, and closeness with spouses/partners, children, other family members, and friends. Multivariate logistic regressions were fit for depressive symptoms and passive suicidal ideation separately, adjusting for demographic, health characteristics, and health-related reasons for moving. Additional models simultaneously adjusted for all social integration measures. Higher nursing home expectations were associated with elevated depressive symptoms (OR: 1.06, 95% CI: 1.01-1.11), major depressive episode (OR: 1.08, 95% CI: 1.02-1.15), and suicidal ideation (OR: 1.10, 95% CI: 1.03-1.16). These relationships persisted even after accounting for social integration. Future research can explore modifiable factors salient to these relationships, such as perceived social support and family care, to inform mental health-targeted interventions as older adults transition into long-term care.


HISTORICAL REDLINING AND COGNITIVE FUNCTIONING AMONG US OLDER ADULTS
Calley Fisk 1 , Jennifer Ailshire 1 , and Katrina Walsemann 2 , 1. University of Southern California, Los Angeles, California, United States, 2. University of Maryland, College Park, College Park, Maryland, United States Historical redlining disproportionately harmed Black and disadvantaged communities by designating them as less desirable for mortgage lending.Residence in neighborhoods historically designated as less desirable is associated with worse health outcomes, though little research exists on older adults.Redlined neighborhoods often have characteristics that increase risk for poor cognitive function among older adults (e.g., greater air pollution and less greenspace).We examine differences in cognitive function trajectories by redlining status over 18 years (1998-2016) using data on 5,527 respondents ages 50 and older from the nationally representative Health and Retirement Study that have been linked to National Community Reinvestment Coalition Historic Redlining Scores Data.Results from multilevel linear regression models -adjusted for individual sociodemographic characteristics -show that baseline level of cognitive function is lower in neighborhoods historically designated as "Declining" (b=-0.61,p<.001) or "Hazardous" (b=-0.95,p<.001) compared with "Best or Desirable".We do not find any association with cognitive change over time.Baseline differences were explained by educational attainment and income for residents of "Declining" neighborhoods, and tract-level affluence and disadvantage for residents of "Hazardous" neighborhoods.Race-stratified analyses showed that the impact of historical redlining on cognitive function was generally similar for Black and White adults, though we found no association between historical redlining and cognitive function for Black residents of "Declining" neighborhoods.Our findings suggest that redlining, as both an historical practice and process affecting the socioeconomic trajectories of individuals and neighborhoods, can shape cognitive health in older adults.
Three million older adults live in long-term care facilities.Transitioning into a nursing home is a major life event that can worsen mental health.Expectedness of nursing home transitions may have implications for mental health; however, this area is understudied.This study examined the relationship between expectations of transitioning into a nursing home in the next five years and depressive symptoms and passive suicidal ideation, and how social integration modified these relationships.Sample included respondents aged 65+ from the 2018 Health and Retirement Study (n=7,944, mean age=73.9,55.4% female, 80.5% Non-Hispanic White).Nursing home transition expectations were modeled continuously (range: 0-100%).Mental health outcomes were assessed by the Composite International Diagnostic Interview-Short Form.Social integration measured composition, frequency of contact, and closeness with spouses/partners, children, other family members, and friends.Multivariate logistic regressions were fit for depressive symptoms and passive suicidal ideation separately, adjusting for demographic, health characteristics, and health-related reasons for moving.Additional models simultaneously adjusted for all social integration measures.Higher nursing home expectations were associated with elevated depressive (OR: 1.06, 95% CI: 1.01-1.11),major depressive episode (OR: 1.08, 95% CI: 1.02-1.15),and suicidal ideation (OR: 1.10, 95% CI: 1.03-1.16).These relationships persisted even after accounting for social integration.Future research can explore modifiable factors salient to these relationships, such as perceived social support and family care, to inform mental health-targeted interventions as older adults transition into long-term care.

THE IMPACT OF LIVING IN MULTIGENERATIONAL NEIGHBOURHOODS ON LONELINESS IN LATER LIFE
Martin Hyde, and Elizabeth Evans, Swansea University, Swansea, Wales, United Kingdom Intergenerational solidarity has been identified as a key factor for effective social functioning.However, evidence suggests that divisions between younger and older generations within Great Britain (GB) have never been greater.Growing residential age segregation is thought to be driving intergenerational division.This, in turn, is assumed to lead to an increased risk of loneliness among older adults.However, to date, this has not been empirically tested.To examine this issue, we created a new measure of multigenerational neighbourhoods, for all lower super output areas in England and Wales.These were linked to individuals aged 50 and over living in England and Wales in 2018/2019 in the UK Household Longitudinal Survey (N = 14,196).Loneliness was measured using the UCLA-3 scale.Multilevel regression analyses were performed.Covariates included, area level deprivation, urban/rural, residential tax band, home ownership, individual age, sex, marital status and financial situation.The results show that the mix of generations within a neighbourhood has a weak (r = 0.33) and non-significant (p=.493) association with loneliness among older adults.To the best of our knowledge this is the first study to directly examine the impact of neighbourhood age diversity on loneliness in later life.Our findings suggest that the mere presence of different generations within a neighbourhood is not a sufficient condition to combat loneliness in later life

A PILOT FAMILY COACHING INTERVENTION FOR PEOPLE WITH TYPE 2 DIABETES AND A FAMILY MEMBER
Kristin August 1 , Kathleen Jackson 1 , and Marsha Rosenthal 2 , 1. Rutgers University, Camden, New Jersey, United States, 2. Rutgers University, New Brunswick, New Jersey, United States Type 2 diabetes is a common chronic condition in later life that requires substantial lifestyle changes.Most diabetes management occurs at home with the help -and sometimes hindrance -of family members.Although coaching has become a common strategy in healthcare to supplement diabetes education, few interventions have prepared family members to be coaches, despite the documented benefit of including family members in chronic disease management interventions.The overall goal of our pilot intervention was to develop and test a family coaching approach to enhance patients' diabetes self-management while preserving relationship quality and both individuals' well-being.Participants were recruited from local diabetes education classes and through provider referrals, and included 20 dyads in the intervention group (patient Mage=59.12) and 20 dyads in the control group (patient Mage=57.06).The intervention, involving 5 interactive group sessions (in-person or virtual) led by a facilitator, covered evidence-based material developed by the investigators on diabetes education and coaching strategies.Behavioral, clinical, emotional, and relational metrics were assessed via a survey at baseline, postintervention, and 3 months later; intervention participants also completed a program evaluation survey and participated in a focus group.Survey findings revealed some positive effects for diabetes self-management behaviors, no effects for short-term clinical markers, negative effects for emotional well-being, and both positive and negative effects for relational well-being.Participants reported being satisfied with the program overall; they indicated learning a lot and having a positive experience.A translation and cultural adaptation of this program for Spanish-speaking populations is currently underway.

A SYSTEMATIC REVIEW OF ENABLERS AND BARRIERS TO CANCER SURVIVORSHIP IN NIGERIA
Candidus Nwakasi 1 , Kafayat Mahmoud 2 , and Darlingtina Esiaka 3 , 1. University of Connecticut,Storrs,Connecticut,United States,2. Boston University,Boston,Massachusetts,United States,3. University of Kentucky,Lexington,Kentucky,United States Background.Nigeria is benefitting from public health and healthcare advancement which is increasing cancer care in the country.As a result, more people are surviving cancer.However, this should not mask the fact that Nigeria, a rapidly aging country which an increased risk of cancer incidence, bears a heavy health burden of about 72,000 cancer deaths per year -this underscores cancer as a leading cause